Article Text
Abstract
Objectives Report preliminary results after 18 months of the new Cervical Cancer Screening Program with primary DNA-HPV test (CCSP-HPV), performed at Indaiatuba city, Sao Paulo State, Brazil.
Methods Indaiatuba has 240 thousand people with 50% assisted by Public Health System (SUS). Until 2017, CCSP was performed by conventional cytology (∼9,000/year), but with <30% coverage of target women (25–64yo). CCSP-HPV was built based in National guideline replacing cytology by Cobas® HPV Test performed at 5-year intervals. Target population comprehend 28,000 women, and the goals will be to reach 80% of coverage after first round (5y). The CCSP-HPV started in October 2017, and here we present the 18-months results compared with previous years (2011–2016, conventional cytology).
Results We considered 9,974 HPV tests in the CCSP-HPV, 95% coverage at 18-months versus 50,708 cytology tests from 2011–2016. 99,2% of the HPV tests were performed in age-range 25–64yo against 77.3% by cytology (0.5% vs 16.6% before the age of 25). Only 22.3% of cytology screening followed guideline for interval (3y). In general, unsatisfactory samples were <0.5% for both programs. Tests results were negative in 96.7% (n=9,643) for HPV tests vs. 98.3% for cytology. HPV-16 and/or -18 were tested positive in 331 (3.3%), and ‘Other 12-HR-HPV’ in 911 (9.1%), with 254 abnormal cytology exams (2.5% colposcopy referral). Total colposcopy referral was 3.4 times more (5.8%/1.7%) than previous opportunistic screening.
Conclusions Organized screening program with primary HPV test indicated high coverage and compliance of target age-range after 18-months, with less unsatisfactory samples, and more referral to colposcopy.